Australia was once a world leader in organ donations, but today its organ donation rate is lower than much of the developed world. The country ranks 20th in the world for donations, despite having a higher than average rate of potential donors, and sits below world leaders such as Spain, Belgium, France and the USA.

Australia’s approach has been to focus on signing up more people to be donors and on encouraging families to consent to donation after the death of a relative. But if Australia wants to be world-leading, that’s not enough.

William Isdale spoke with Aric Bendorf about what needs to change if Australia is to, once again, become a leader in organ donation.

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Australia has never had a great deceased organ donor rate – and it fell last year. But proposed guidelines from the National Health and Medical Research Council (NHMRC) could change how donor organs are obtained and allocated for the better.

DonateLife Australia, the government body responsible for organ donation and transplantation, has just announced there were 16.1 deceased organ donors per million people in Australia in 2014. This represents a 5% decline from 2013 and maintains Australia’s deceased organ donor rate in the bottom half of OECD countries. It’s important to note, though, that the 2013 rate was the highest ever recorded.

More people in this country die waiting for organ transplants than in many other developed countries, but it’s not all bad news: Australia has a long and successful history in organ transplantation.

Outcomes following organ transplantation are world leading – more than 90% of patients who receive a kidney, heart, heart-lung or liver transplant are alive a year later. And more than 90% of people who receive a transplant have normal function of their new organ. The number of organs retrieved from each deceased donor is also higher than in many countries.

Estimates suggest more than two million people worldwide would benefit from an organ transplant. While the donation rates vary greatly between countries, the contrast between the increasing numbers of people in need and the inadequate numbers of organs being donated mean many will die while they wait.

Last night, ABC’s Four Corners screened Tales from the Organ Trade, an HBO documentary that highlights the desperation that links the world’s poor, who sell their organs, together with first-world recipients who buy them on the black market.

While accurate statistics are difficult to find, some suggest that up to 15% of the world’s transplants are performed using illegally obtained organs via an international black market web of organ brokers. The brokers bring recipients and donors together with transplant surgeons working out of fly-by-night medical clinics. The process is unregulated, illegal and the risks to both donor and recipient are high.

The documentary raises challenging questions about this illegal trade in organs that sometimes benefits both the donor and recipient and other times imperils the well-being of both. There are, no doubt, many more untold horror stories.

Australia has some of the world’s highest organ transplant success rates, but, for almost two decades, our deceased organ donation rates have been among the lowest in the developed world. In other words, when it comes to organs, we’re no good at finding them but we’re the best in the world at transplanting them.

There’s still only a very limited supply of organs available for those who desperately need them and each year people die waiting for a life-saving transplant.

For many years now, enormous attention (and funding) has been devoted to finding ways of raising the organ donation rate. Between 1989 and 2008, more than 20 public and government-led initiatives were launched to address issues believed to be its cause. Unfortunately, they’ve proved ineffective and cumulatively resulted not in an increase in donation, but a decline of around 20%.

These failures illustrate misunderstandings about what the country can do to raise its organ donation rates. The idea that Australia is somehow fundamentally different to world leading donor countries, for instance, and incapable of matching their success in organ donation is false. A number of misconceptions lead to such conclusions, and they constitute five myths about organ donation. Continue reading →